Provider Demographics
NPI:1942981832
Name:REUTER, COLLEEN (MED, LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:REUTER
Suffix:
Gender:F
Credentials:MED, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 TECATE TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-4335
Mailing Address - Country:US
Mailing Address - Phone:650-504-6681
Mailing Address - Fax:
Practice Address - Street 1:4113 TECATE TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78739-4335
Practice Address - Country:US
Practice Address - Phone:650-504-6681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health